Objective To study the effect of medial collateral ligament(MCL)release on the squatting motion followling total knee arthroplasty(TKA)and provide reference data for ligament release during knee replacement surgery.Methods Based on CT and MRI images of a volunteer,a three-dimensional(3D)geometric anatomical model of the natural knee joint including bone tissues and major soft tissues was established.A finite element model of the artificial knee joint was established by simulating TKA surgery.The squatting motion after 30％release of the upper end,lower end,and both ends of the MCL was simulated,and motion characteristic data of the knee joint at flexion/extension angles from 0° to 135° were obtained.Results The effects of ligament release at different locations on knee squatting motion varied.After releasing the lower end,the medial translation,posterior translation,superior translation,and adduction of the femur relative to the tibia increased by 13.74％,3.83％,9.74％,and 2.37％,respectively,while the external rotation decreased by 36.8％.After releasing the upper end,the medial translation and posterior translation increased by 10.65％and 10％,respectively,while the superior translation,adduction,and external rotation decreased by 4.52％,33.89％,and 67.1％,respectively.After releasing both ends,the medial translation,posterior translation,and superior translation increased by 14.77％,9.39％,and 22.56％,respectively,while the adduction and external rotation decreased by 15.62％and 47.3％,respectively.Conclusions After MCL released,the medial translation,anterior translation,superior translation,and abduction of the femur relative to the tibia increased,while the external rotation decreased.Releasing the lower end had the least effect on these femoral movements,showing an obvious advantage.

AIM To investigate the mechanism of Jiedu Yizhi Formula on cognitive function and neuroinflammation in a mouse model of Alzheimer's disease(AD).METHODS 50 APP/PS1 double transgenic mice were randomly divided into the model group,the donepezil group,and the low-dose,moderate-dose,and high-dose Jiedu Yizhi Formula group(1.78,3.56 and 7.12 g/kg),with 10 mice in each group,in contrast to the 10 WT mice of the blank group.Following anesthesia administration and 8-week oral gavage regimen with respective drugs,all mice underwent final tissue sample collection.The mice had their learning and memory ability assessed by Morris water maze and nesting behavior scores;their pathology of brain tissue and Aβ expression observed using HE,Nissl and IHC staining;their polarization of microglia and the expression of inflammatory factors in hippocampal tissue detected by IF and ELISA;their hippocampal expression of PI3K/Akt/mTOR signaling pathway detected by RT-qPCR and Western blot.RESULTS Compared with the blank group,the model group had lower scores in total swimming distance,frequency in crossing the platform,residence time in the target quadrant,and nesting behavior scores(P＜0.05,P＜0.01);prolonged evasion latency(P＜0.01);more disorganized arrangement of pyramidal cells,solidification and deep staining,unclear demarcation,irregular cell shapes,reduction of Nyctinidia,and increased Aβ deposition in the brain tissue(P＜0.01);elevated expression of hippocampal microglia M1-type markers CD16/32 and lba-1(P＜0.01);decreased levels of M2-type marker CD206(P＜0.05);elevated levels of TNF-α and IL-1β(P＜0.01);decreased expressions of IL-13 and IL-4(P＜0.01);and decreased levels of PI3K,Akt and mTOR mRNA,and reduced p-PI3K,p-Akt and p-mTOR protein expressions(P＜0.01).Compared to the model group,the donepezil group and the Jiedu Yizhi Formula groups showed statistically significant improvements in the aforementioned indexes(P＜0.05,P＜0.01),with the magnitude of improvement being higher in the high-dose Jiedu Yizhi Formula group.CONCLUSION Jiedu Yizhi Formula suppresses microglia Ml-type polarization while enhancing M2-type polarization via activation the PI3K/Akt/mTOR signaling pathway,which subsequently reduces inflammatory cytokine secretion.This mechanism attenuates Aβ deposition in brain tissues and ameliorates cognitive dysfunction in AD mouse models.

Aim To investigate the role of FRMD4A in autophagy of placental trophoblast cells in preeclampsia(PE).Methods The placental tissues and clinical data of normal pregnancy and PE were obtained,and the histopathological changes were observed by HE staining.An in vitro model of hypoxia-induced HTR-8/SVneo trophoblast cells was established.The expres-sions of LC3B Ⅱ/Ⅰ and p62 in placental tissues and hypoxic cell models were analyzed by Western blot.The expression of FRMD4A was detected by qRT-PCR,Western blot and immunofluorescence,and the correlation between the expression level of FRMD4A and the clinical characteristics of the subjects was ana-lyzed by Pearson correlation analysis.Hypoxia induced trophoblast cells were transfected with si-FRMD4A,and the expression of LC3 B Ⅱ/Ⅰ and p62 was analyzed by Western blot.Results Compared with the normal group,the expression of LC3B Ⅱ/Ⅰ in PE placental tissues and hypoxia-induced trophoblast models was significantly upregulated,while the expression of p62 was significantly downregulated.Meanwhile,the ex-pression of FRMD4A increased significantly.Moreo-ver,its expression was positively correlated with the maternal systolic blood pressure,diastolic blood pres-sure,and platelet count,but negatively correlated with the neonatal weight(P＜0.01).In addition,hypoxia-induced trophoblast cells transfected with si-FRMD4A showed a significant decrease in LC3B Ⅱ/Ⅰ and an increase in p62 expression.Conclusions The expres-sion of FRMD4A is upregulated in PE placenta and hy-poxia-induced trophoblast cell model.Interfering with it can significantly hinder the autophagy process of trophoblast cells,suggesting that it may serve as a po-tential molecular target to participate in the pathologi-cal process of PE.

BACKGROUND:Unlike non-inflammatory cell apoptosis,pyroptosis is a form of inflammatory cell death,characterized by membrane integrity disruption and release of pro-inflammatory intracellular substances.Thus,it is associated with various diseases.The sirtuin family is a group of histone deacetylases dependent on nicotinamide adenine dinucleotide.In addition to deacetylation,it also possesses other enzymatic activities such as desuccinylation,demalonylation,adenosine diphosphate-ribosylation and playing crucial roles in the regulation of pyroptosis.OBJECTIVE:To review the role of the sirtuins in pyroptosis.METHODS:The first author conducted a search on PubMed,Web of Science,CNKI,and WanFang Data from inception to March 2024,using the Chinese and English search terms"Sirtuins,Sirtuin1,Sirtuin2,Sirtuin3,Sirtuin4,Sirtuin5,Sirtuin6,Sirtuin7,pyroptosis",resulting in the inclusion of 71 articles.RESULTS AND CONCLUSION:(1)The sirtuin family all participates in the regulation of pyroptosis.(2)Overexpression of sirtuin1 and sirtuin4 can inhibit pyroptosis through various pathways,thus alleviating the damage caused by pyroptosis to the organism.(3)In addition to affecting the classical pathway of pyroptosis,sirtuin3 can also inhibit pyroptosis by enhancing mitochondrial reactive oxygen species scavenging capacity and mitosis.(4)Sirtuin5 is involved in the regulation of intracellular metabolism and energy balance,including energy intake,storage,and consumption.(5)Sirtuin6 can influence pyroptosis through various pathways and also affect macrophage M1 polarization,generation of reactive oxygen species,and cleavage of pyroptosis-related factor sclerotin D to inhibit pyroptosis.(6)Overexpression of sirtuin7 can suppress pyroptosis.(7)Sirtuin2,unlike other family members,can restrain pyroptosis only after knockdown,but there are fewer reports,requiring more in-depth and comprehensive research.

Objective To investigate the effects of three types of twin-block(TB)appliances on the stress and displacement of anterior teeth,periodontal ligaments,and alveolar bone.Methods A three-dimensional(3D)finite element model was constructed,including maxillofacial bones,articular discs,teeth,and periodontal ligaments.Three types of twin-block appliances were designed:classic twin-block(classic-TB),twin-block with acrylic capping(capping-TB),and clear twin-block aligner(CTBA).All appliances had an inclination angle of 70°,and a masticatory force of 200 N was applied to their inclined planes.The finite element method was used to analyze the stress distribution and displacement differences of anterior teeth.Results All three types of TB appliances induced lingual tilting of maxillary anterior teeth and labial tilting of mandibular anterior teeth.The CTBA group showed the greatest lingual displacement and stress of maxillary anterior teeth,with a maximum stress of 30.6 MPa,while the mandibular anterior teeth in this group exhibited the smallest labial displacement(approximately 0.02 mm)and stress.Additionally,the CTBA group had the lowest compressive stress in mandibular anterior teeth,periodontal ligaments,and alveolar bone,whereas the classic-TB group had the highest.Conclusions In the treatment of Angle Class Ⅱ malocclusion,classic-TB(with or without acrylic capping)causes labial inclination of mandibular anterior teeth.Compared with classic-TB,CTBA effectively reduces the compressive stress and displacement of mandibular anterior teeth,potentially minimizing adverse periodontal risks.However,attention should be paid to the lingual displacement of maxillary anterior teeth.

Objective:This study aimed to investigate the atherosclerotic cardiovascular disease(ASCVD)risk stratification and target achievement of lipid and blood pressure control among community-based hypertensive patients,with the goal of optimizing integrated management strategies.Methods:A total of 2832 hypertensive patients registered in 2021 at the Bicheng Community Health Service Center in Bishan District of Chongqing,were included.Baseline data were collected through retrospective analysis of health records.Non-high-density lipoprotein cholesterol(non-HDL-C)levels and estimated glomerular filtration rate(eGFR)were calculated.ASCVD risk stratification was performed,and target achievement for lipid and blood pressure control were analyzed,including comparisons among patients with different comorbidities.Results:Based on ASCVD risk stratification,patients were categorized as follows:ultra-high risk(22 cases,0.78％),very high risk(111 cases,3.92％),high risk(1324 cases,46.75％),moderate risk(997 cases,35.20％),and low risk(378 cases,13.35％).The LDL-C target achievement rate was 4.55％(1/22)in the ultra-high risk group and 15.32％(17/111)in the very high risk group,with blood pressure target achievement rate of 18.18％(4/22)and 11.71％(13/111),respectively.In the high-risk group,LDL-C and blood pressure target achievement rate were only 4.76％(63/1324)and 8.08％(107/1324),while moderate-risk groups showed 25.68％(256/997)and 26.18％(261/997),respectively.The low-risk group achieved 99.74％(377/378)LDL-C target achievement and 30.69％(116/378)blood pressure target achievement.Patients with ischemic stroke had a significantly higher lipid target achievement rate(13.73％,7/51)compared to non-ischemic stroke patients(6.40％,178/2781)(P＜0.05).Similarly,those with coronary heart disease(12.65％,13/87)exhibited higher lipid target achievement than non-coronary heart disease patients(6.27％,172/2745)(P＜0.05).However,no significant difference was observed between hypertensive patients with diabetes(8.04％,52/647)and non-diabetic patients(6.09％,133/2185)(P＞0.05),or between those with chronic kidney disease(CKD)stages 3/4(6.72％,16/238)and non-CKD 3/4 patients(6.52％,169/2594)(P＞0.05).Conclusion:Over half of the community-based hypertensive patients were classified as high-risk or above in ASCVD stratification,yet their lipid and blood pressure target achievement rates were markedly suboptimal.Hypertension patients with comorbidities,particularly diabetes or CKD stages 3/4,showed poor lipid target achievement.These findings underscore the necessity of incorporating ASCVD risk stratification into community management assessments for hypertensive patients,enhancing personalized management for high-risk populations,and prioritizing lipid target achievement in those with diabetes or CKD stages 3/4.

Objective:This study empirically analyzes the relationship between outpatient and inpatient services under the impact of healthcare payment reform,and evaluates the effects of the reform.Methods:Data from healthcare services and basic medical insurance payments in eight districts of Jinhua City from 2020 to 2022 were used.A fixed-effects model for outpatient and inpatient services was constructed to analyze the impact of healthcare payment reforms and outpatient services on inpatient services.Results:The DRG-based payment had a significant positive effect on inpatient visits and a significant negative effect on employee basic medical insurance inpatient costs.The"capitation+APG"outpatient payment policy had a significant negative effect on inpatient visits and a significant negative effect on residents'basic medical insurance inpatient costs.The interaction between outpatient payment and outpatient visits had a significant negative effect on employee basic medical insurance inpatient visits,while the interaction between outpatient payment and outpatient costs had a significant negative effect on both overall and employee inpatient costs.Conclusions:The DRG payment reform led to an increase in inpatient visits and a reduction in employee basic medical insurance inpatient costs.The outpatient"capitation+APG"payment reform reduced inpatient visits and lowered residents'basic medical insurance inpatient costs,thereby slowing down the complementary effect between outpatient and inpatient services.

Objective To study the effect of medial collateral ligament(MCL)release on the squatting motion followling total knee arthroplasty(TKA)and provide reference data for ligament release during knee replacement surgery.Methods Based on CT and MRI images of a volunteer,a three-dimensional(3D)geometric anatomical model of the natural knee joint including bone tissues and major soft tissues was established.A finite element model of the artificial knee joint was established by simulating TKA surgery.The squatting motion after 30％release of the upper end,lower end,and both ends of the MCL was simulated,and motion characteristic data of the knee joint at flexion/extension angles from 0° to 135° were obtained.Results The effects of ligament release at different locations on knee squatting motion varied.After releasing the lower end,the medial translation,posterior translation,superior translation,and adduction of the femur relative to the tibia increased by 13.74％,3.83％,9.74％,and 2.37％,respectively,while the external rotation decreased by 36.8％.After releasing the upper end,the medial translation and posterior translation increased by 10.65％and 10％,respectively,while the superior translation,adduction,and external rotation decreased by 4.52％,33.89％,and 67.1％,respectively.After releasing both ends,the medial translation,posterior translation,and superior translation increased by 14.77％,9.39％,and 22.56％,respectively,while the adduction and external rotation decreased by 15.62％and 47.3％,respectively.Conclusions After MCL released,the medial translation,anterior translation,superior translation,and abduction of the femur relative to the tibia increased,while the external rotation decreased.Releasing the lower end had the least effect on these femoral movements,showing an obvious advantage.

With the rapid development of generative artificial intelligence(GAI)technologies,their widespread application in academic research and writing is continuously expanding the boundaries of sci-entific inquiry.However,this trend has also raised a series of ethical and regulatory challenges,inclu-ding issues related to authorship,content authenticity,citation accuracy,and accountability.In light of the growing involvement of AI in generating academic content,establishing an open,controllable,and trustworthy ethical governance framework has become a key task for safeguarding research integrity and maintaining trust within the academic community.This expert consensus outlines ethical requirements across key stages of AI-assisted academic writing-including topic selection,data management,citation practices,and authorship attribution.It aims to clarify the boundaries and ethical obligations surrounding AI use in academic writing,ensuring that technological tools enhance efficiency without compromising in-tegrity.The goal is to provide guidance and institutional support for building a responsible and sustainable research ecosystem.

Objective To investigate the clinical efficacy of dual-layer artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft in the treatment of chronic refractory wounds.Methods A total of 60 patients with chronic refractory wounds were prospectively selected and divided into the control group(30 cases)and the observation group(30 cases)according to random number table method.In the control group,patients were treated with simple vacuum sealing drainage in the first phase and autologous split-thickness skin graft in the second phase.In the observation group,patients received dual-layer artificial dermis combined with vacuum sealing drainage in the first phase and autologous split-thickness skin graft in the second phase.The survival of autologous split-thickness skin,the incidence of adverse reactions,and the degree of scarring[Vancouver scar scale(VSS)score]of patients in the two groups were observed.The degree of pain before and after treatment[visual analogue scale(VAS)score],serum matrix metalloproteinase 13(MMP-13)level,serum tissue inhibitor of metalloproteinase 1(TIMP-1)level,and MMP-13/TIMP-1 ratio of patients in the two groups were compared before and after treatment.Results After treatment,the survival rate of autologous split-thickness skin in the observation group was better than that in the control group,the incidence of adverse reactions,the VSS score of the graft site and the donor site,and the pain degree in the observation group was lower/lighter than those in the control group,and the above differences were statistically significant(P<0.05).After treatment,the serum MMP-13 level and MMP-13/TIMP-1 ratio of patients in the two groups were lower than those before treatment,and the serum TIMP-1 level was higher than that before treatment,and the changes in the observation group were greater than that in the control group,and the differences were statistically significant(P<0.05).Conclusion Dual-layer artificial dermis combined with vacuum sealing drainage and autologous split-thickness skin graft have significant effects in the treatment of chronic refractory wounds,which can increase the survival rate of autologous split-thickness skin,reduce adverse reactions,alleviate scar conditions and pain degree,and regulate serum MMP-13 and TIMP-1 levels.